The Mediterranean Diet emphasizes whole, local foods over weight loss diets. Photo / 123rf
It’s hailed as one of the healthiest diets in the world, fighting heart disease, Type 2 diabetes and certain cancers. Here’s how to do it.
Towards the end of the 1950s, researchers embarked on a mission to find the world’s healthiest diet. The Seven Countries Study, which ran until the early 1980s, looked at the eating habits and lifestyles of over 12,000 middle-aged men living in seven different countries, and their rates of heart disease and mortality.
The countries that consistently came out on top were the Mediterranean ones. The researchers found that those who lived in countries such as Greece and Italy had the lowest rates of heart disease, largely due to what they were eating. The concept of the Mediterranean Diet was born, and since then an exhaustive list of studies has found that as well as protecting our hearts, it can reduce the risk of Type 2 diabetes and certain cancers, increase longevity, boost brain health and support healthy weight loss.
“But it’s a lifestyle rather than a diet,” points out Sam Rice, the Telegraph nutritionist and author of Supercharge Your Diet. “It’s based on living a certain way and eating whole, seasonal foods that are locally available in the Med, rather than a diet contrived for weight loss. It promotes eating a wide variety of healthy foods, including lots of colourful fruit and vegetables, nuts and fish, with olive oil, the world’s healthiest fat, at its core.”
But can those of us who don’t live in the Med still reap the health rewards? According to the experts, we can. Here’s everything you need to know…
“This diet has multiple, well-documented health benefits, including heart and brain health, thanks to all the healthy fats,” says Rice. “It’s also naturally anti-inflammatory, which lowers the risk of all sorts of chronic illnesses from dementia to arthritis.”
It’s particularly renowned for protecting heart health. In a 2018 study, US researchers studied almost 26,000 women and found that those who followed a Mediterranean diet had a 25 per cent reduced risk of heart disease, largely due to changes in blood sugar levels, inflammation and body mass indexes (BMIs).
The Mediterranean diet can also help those who already have heart disease. In 2016, Italian researchers studied people with a history of heart attacks, strokes and hardened arteries, and found that those who ate this way were 37 per cent less likely to die during the study, even after adjusting for factors like their age, gender and activity levels.
The researchers, from the IRCCS Neuromed Mediterranean Neurological Institute, also found that eating plenty of vegetables, nuts and olive oil in particular could be more effective than heart drugs, such as statins, in treating disease.
The diet’s brightly coloured fruits and vegetables can also protect against cancer, thanks to the high levels of antioxidants and anti-inflammatory compounds found in their colourful skins. In a 2022 study, the diet was found to lower the risk of recurrence and mortality with breast, colorectal and prostate cancer.
Lastly, food aside, living like you live in the Med will also keep you healthier: in 2023, researchers at La Universidad Autonoma de Madrid and Harvard T.H. Chan School of Public Health, found that adopting the lifestyle habits of people living in Greece, Italy and Spain can lead to a longer and healthier life - having strong social ties and taking short daytime naps were found to be particularly beneficial. In fact, the study revealed that those who adhered most to the “physical activity, rest, and social habits and conviviality” part of the Mediterranean lifestyle had the lowest risk of heart disease.
According to experts, this lifestyle choice will make for a healthier old age, helping to reduce brain age and increase life expectancy. In June 2023, Israeli scientists found that a slightly tweaked version of the diet - where green tea, walnuts and a green smoothie were added - helped to improve brain health in overweight adults (obesity has been found to age the brain).
The researchers, from the Ben-Gurion University of the Negev, recruited 102 overweight people aged 52 and over, and asked them to follow a ‘green Mediterranean’ diet for 18 months. They found that more than half had a younger brain age by the end of the study, with a one per cent drop in BMI resulting in a nine-month drop in brain age.
It also has positive effects in the field of mental impairment. In 2023, a study led by Newcastle University and published in the BMC Medicine journal found that a Mediterranean diet could reduce dementia risk by almost a quarter.
Meanwhile, a Harvard study revealed that following a Mediterranean-style diet could lengthen your life. Researchers found that of the 4600 women asked to follow the diet, those who did were more likely to have longer telomeres, which ‘sit’ at the end of our chromosomes and protect our DNA. Over time these gradually shorten, weakening our defences. The researchers found that the diet protected telomeres from fraying and shortening, which is linked to a longer life expectancy.
“The Mediterranean diet is not focused on weight loss per se, but rather a way of eating a healthy, balanced diet that provides the body with optimum nutrition,” says Rice. “However, the effects of eating this way can certainly help to maintain a healthy weight because the body feels satiated thanks to the good balance of complex carbs, lean protein, healthy fat and fibre. This prevents cravings and regulates appetite.”
It also supports gut health, says Rice, which plays a role in weight management. Several studies have found that obesity is associated with lower gut bacteria diversity (you can keep yours diverse by eating a wide range of plants, beans and whole grains).
But while it was never designed to be a weight loss diet, in one study involving more than 30,000 people living in Italy, researchers found that those who followed the Mediterranean diet for about 12 years were less likely to become overweight or obese. A review of five studies by Harvard Health found that, on average, people lost between 9 and 22lbs after one year following a Mediterranean-style diet compared to 6 and 11lbs on a low-fat one.
“The only thing to watch out for is not eating too many nuts, which are very calorific,” says Rice. “Intake should be limited to around 30g per day [roughly a small, cupped handful].”
This diet is also full of foods like cheese and olive oil that, while nutrient-rich, contain a fair amount of calories which can lead to weight gain if eaten in large portions. For example, two tablespoons of olive oil contains around 240 calories, so remember to drizzle rather than pour.
However, according to Gabriela Peacock, a nutritionist to the royals and the author of 2 Weeks To A Younger You, it’s best not to get too hung up on this: “Olive oil contains monounsaturated fats, which have been shown to extend lifespan as they reduce the risk of heart disease by improving insulin sensitivity, boosting immunity, and supporting healthy weight loss. It’s no coincidence that olive oil is a key component of the diet in the Mediterranean, where they live long and sprightly lives.” Other sources of monounsaturated fats include avocado, nuts and seeds.
Another component of the diet is cheese, which is high in saturated fats and can increase ‘bad’ cholesterol. However, cheese is also a good source of protein, calcium (important for bone health) and B vitamins, which help the body release energy from food. Meanwhile, a recent study found that people who ate dairy were less likely to get heart disease than those who ate the same amount of saturated fat from red meat. So, limit your intake and pick cheeses that are as minimally processed as possible, such as feta, halloumi, Parmesan and mozzarella.
While red meat is not banned if you’re following the Mediterranean diet, it should be limited. “Think of red meat as a treat. And when you do have it, choose fresh, preferably organic lean red meat over the cured or smoked varieties like salami, which is processed,” says Peacock.
Meanwhile, while the Mediterranean Diet does include carbohydrates, it tends to steer away from refined grains, such as white rice, pasta or bread.
“Carbohydrates are a major source of energy for the body, and you’ll find them in the Med,” says Peacock. “But not all carbs are created equally, and some have a higher sugar or fibre content than others.”
In short, Peacock says, if refined, white, or sugary carbohydrates become too dominant in your diet, weight gain will be a side effect. “It also accelerates the ageing process by continuously raising inflammation levels, unbalancing hormones, and increasing insulin resistance.” However, she advises that it’s important to look at the overall picture and while a bowl of white pasta will spike insulin levels, a bowl of wholegrain pasta with a Bolognese sauce, which contains proteins and fats, will have less of an effect on your insulin and blood sugar levels.
Refined sugar is also generally off limits on the diet and the “mortal enemy of longevity”, according to Peacock. “Over-consumption of sugar is one of the primary causes of chronic inflammation and its merry band of diseases.” Namely, heart disease, Type 2 diabetes and cancer.
“The only things to watch might be your iron intake if you aren’t eating much red meat, and calcium if you’re not eating much dairy,” says Rice. “If this is the case, be sure to eat plenty of other iron-rich foods like oily fish, shellfish, leafy greens like spinach and broccoli, mushrooms, beans, quinoa and pumpkin seeds, and include some full-fat milk or yogurt daily to increase your dairy intake.” Foods that help your body absorb iron more efficiently include citrus fruits, peppers and tomatoes, which are abundant in the Mediterranean diet, so tuck into those.
Lastly, Rice says: “While it might not be easy to get those big juicy Mediterranean tomatoes in drizzly Britain, the main tenets of the diet are to cook from scratch, focus on whole foods, particularly plants, eat plenty of fish and stick to extra virgin olive oil. This is doable anywhere. But another downside is it can be a little expensive, so a good idea is to focus on plants that are in season for tastier and cheaper results.”
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